Considering the Pro's and Cons

There are lots of things to think about when deciding whether to use a known donor or to purchase sperm from a sperm bank. Cost, convenience, future family dynamics, legality, and medical history and health are all factors to consider.​​

This subject is often one of the first things that must be figured out by LGBTQ couples and single people trying to conceive, but straight couples may also be faced with a decision about where to get donor sperm, if the male partner is struggling with infertility.

For azoospermic couples (a fancy work for "without sperm") who want to carry their own child and be their child’s sole parents, there are three main choices when it comes to acquiring sperm:

1. Use a known donor (friend, colleague, or acquaintance) for fresh sperm.2. Use a known donor and have their sperm frozen.3. Purchase frozen sperm from a sperm bank.

​There are advantages and drawbacks to each one of these choices. Lets take a closer look...

Using a Known Donor for Fresh Sperm

Advantages:​

- It’s free. Using a known donor for fresh sperm can save you literally thousands, or even tens of thousands of dollars (depending on how long it takes for you or your partner to get pregnant), so this is a huge advantage.

- Live sperm is stronger. It lives longer (up to three days, vs 24 hours with frozen sperm) and there is more of it (in most cases, more than half of sperm die during the freezing and thawing process).

- No strangers need be involved. You can do this in the privacy of your own home, with no doctors, no sterile clinic rooms. This helps keep some of the "romance" alive in the process. And, for LGBTQ couples in areas where LGBTQ-friendly clinics are uncommon, this can make a huge difference in your overall experience.

- If you have a good relationship with the donor, it can be pretty cool to have actual contact with the other person who contributed biologically to your child. Not only does it give you access to your donor’s whole medical and family history, but depending on the agreement you all have, your child may be able to see or even meet and know their donor and/or the donor’s family.

- You could potentially use a member of your partner’s family - which is the closest thing you’ll be able to come to having a baby that is biologically related to both of you (read on for some possible disadvantages to this).

Disadvantages:

- You really have no idea of their disease status. No matter how much you trust your donor, there is always the chance that you or your partner may be exposed to an STI. Keep in mind that this is a risk many people are also willing to take when having unprotected sex, most of the time with no issues. Sperm that goes through a sperm bank or reproductive clinic must be tested for STI’s, whether it’s from a known donor or not.

- You also may have no idea of their sperm count - and , since 50% of fertility issues are with the count and quality of the sperm, it would be a good idea to get your donor’s sperm count checked before you start.

- You can’t do IUI (intrauterine insemination) with fresh sperm. Which is usually fine, but might not be a good option for people who have any issues such as cervical scarring (which can happen after a LEEP or similar procedure).

- Things can get weird with the donor, or with the donor’s family. It’s important to have a clear legal contract with the donor that outlines each parties rights and responsibilities. This should be signed by everyone involved and notarized. Even with this, strange feelings and behaviors can come up when there is a baby involved. In addition, if you use one of your partner’s family members, this can sometimes make things uncomfortable with the larger family dynamic.

- The non-carrying partner may feel threatened by the presence (or potential presence) of the known donor in the child's life. Being the "non-biological" parent of a child conceived with donor sperm can feel quite vulnerable. It's totally okay to feel this way, and to voice discomfort over the potential presence of a genetically related non-parent in your child's life. All of these feelings and dynamics should be part of the pre-baby discussion, or explored with a qualified couples counselor (I am a huge fan of non-crisis couples counseling).

Using a Known Donor for Frozen Sperm

Advantages:

- The sperm bank will (and must) test the sperm for all STI’s and tell you the sperm’s count and motility.

- You can bank a bunch of sperm for future pregnancies, without having to worry about whether or not your donor will still be available by then.​- If your donor lives far away, you can have a few dozen vials shipped to you wherever you are, without having to travel every 28 days.

- It may be slightly to moderately less expensive than buying sperm from a sperm bank, depending on how much sperm you end up needing. You don’t have to pay for the sperm itself, but you still have to pay half a dozen other fees: for testing, preparing, and storing the sperm. The fees for getting set up with a fertility clinic that will test, prep, and freeze the sperm can be upwards of $2,500, with an additional fee of 150-300 for each sample collected. Depending on your donor's sperm count, one sample may yield 2-4 vials of sperm. If you end up doing several IUI's or intravaginal inseminations, this can save you money in the long run. But if you get pregnant on the first try, the fees for set up and preparation for all those vials will quite a bit more than you would have paid for a single vial of sperm from a sperm bank. Same goes for IVF - in most cases, one vial is all that is needed for the creation of multiple embryos.​- Frozen sperm can be washed and used for either IUI or IVF, or you can request that the sperm is left unwashed and it can be used for inseminations at home.

Disadvantages:

- Your known donor will have to go through a lot of tests - including a psychiatric test. This can feel pretty insulting, especially considering most couples don’t have to undergo any type of psychiatric testing to become parents. But the real reason for this, in addition to most of the other testing, is about liability for the sperm bank or reproductive clinic, rather than any judgement about LGBTQ families or individuals requiring donor sperm.

- Some clinics require a six month wait between when the sperm is first donated and when it is available for use. This is so that the sperm can be retested for HIV after the six month window. This can be a real disappointment if you are wanting to get started right away.

Purchasing Anonymous Sperm from a Sperm Bank

Advantages:​

- The donor is totally out of the picture, legally and practically. It’s just between you and your partner, or just you if you’re trying to conceive on your own.

- All the testing, processing, and other fees are represented neatly in the price of the sperm.

- All the sperm that is ready for purchase has a minimum sperm count and motility, it’s tested negative for STI’s, and it has already passed the 6 month window for HIV testing.

- There is a community built around donor-conceived families, donor siblings, and the whole process of this type of pregnancy.

Disadvantages:​

- It’s expensive. We’re talking up to $800 a pop for frozen and washed sperm. You’ll also have to consider shipping fees if your bank is far away, and storage fees if you purchase more than one vial at a time.

- Some sperm banks have really fishy politics. Theoretically, a sperm bank should limit the number of families that have gotten pregnant from a single donor’s sperm. However, some banks are not very honest in this regard and a child of a certain donor's sperm may find out later in life that they have 20, 30 or as many as 50 donor siblings. In addition, some banks don’t screen for genetic abnormalities, or may even allow sperm to be purchased that has known genetic abnormalities. For these reasons, it’s important that you choose a bank that is reputable.

- Your child won’t have the option of meeting their donor till they are 18 (in the case of an identity-release donor), or ever (in the case of an anonymous donor). For some kids, this is no big deal, but for others this may feel like a significant loss. In addition, no matter how thorough your sperm bank's initial donor intake is, you will always be missing certain aspects of your child's family health history. But again, this is no different from many families in which health history is not talked about, or is lost due to an absent parent or an adoption.

Choices, Choices!

It can be confusing to make decisions about how to start your family when faced with so many choices. But with a little forethought, a lot of discussion before hand, and maybe a few sessions with a couples counselor trained in fertility counseling, the right decision for your family will make itself apparent over time.

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​This blog is intended for educational purposes only.Information expressed herein does not constitute medical advice and in no way should be used as a substitute for the advice and attention of a qualified medical practitioner.

While many states offer regular medical licensing to naturopathic physicians, Michigan does not currently offer licensure to naturopathic doctors. I am licensed as a Naturopathic Doctor (ND) in the State of Vermont. In Michigan, until our licensing bill is passed, naturopathic medicine is not intended to diagnose, treat, or cure any disease and is not intended as a substitute for regular medical care. Because of this I work locally under the title Naturopathic Health Consultant.